Tag Archives: scarcity

Looking at the relationship between scarcity, unhealthy behavior

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health, working to help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network. Send questions or suggestions to joe@healthjournalism.org or @rojasburke.

People with low socioeconomic status are more likely to act in ways that harm their health compared with those higher on the ladder of income and social stature.

On average, they smoke more, they exercise less and their diet is less wholesome. As a group, they are even less likely to use seatbelts. Researchers have struggled for years to understand why this is so. It involves more than the inability to pay for goods and services that promote health. Cigarettes are expensive, after all. Walking and many other forms of exercise don’t require money, and neither does clicking a seatbelt.

Photo by Roman Pavlyuk via Flickr

One explanation that’s drawing a lot of media attention, perhaps to the point of going overboard, is the idea that poverty overloads the capacity of the brain to make sound decisions. This is the hypothesis advanced in “Scarcity,” an important, fascinating – and expertly publicized – book by behavioral economist Sendhil Mullainathan and cognitive psychologist Eldar Shafir that has been the basis for dozens of news reports since it was published in August. Continue reading

Keep in mind unintended consequences of price transparency

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health, working to help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network. Send questions or suggestions to joe@healthjournalism.org or @rojasburke.

Image by Tim Caynes via flickr.

Image by Tim Caynes via flickr.

It’s always a good idea for reporters to think about unintended consequences, especially when we’re talking about the latest, trendiest policy fixes. I’m thinking of such ideas as requiring people who need medical care to put more “skin in the game” and to choose medical services with more attention to the prices. What could go wrong?

In an eye-opening essay for The New Yorker, Lisa Rosenbaum explores the consequences for people with limited means to pay. She makes the case that injecting price transparency into patient-doctor encounters could, if not done thoughtfully, “end up hurting most those we are trying to help.”

Rosenbaum, a cardiologist, starts with a first-person account of suffering a serious injury, and reflects on how pain and fear in such circumstances alter the way we think and make decisions, even among those who are pretty well off: Continue reading